Civil Discourse Now

Where the far left and far right overlap for fun and enlightenment

Single payer health care would make the debate over Planned Parethood funding moot.

   In the United States, health care costs twice as much per capita as in the second-most expensive country for health care, according to the National Center for Health Studies. Yet we rank 37th in the World in health care quality and 42nd in adult mortality rates.

   The people who profit from this system are the major shareholders in health insurance companies. In the meantime, the rest of us die sooner than we should. I pay nearly $1,000 per month for health insurance. I am self-employed. Many insurance policies are tied to employers.     Why do we have health insurance tied to employment? That puts businesses in the United States at a disadvantage in their competition with businesses from other countries. Health insurance here is a big chunk of over head. Companies from countries with national health care do not have such worries.

   Lawrence O’Donnell made a good point last night about single payer—i.e., national health care, like every other industrialized nation in the world has. Funding of Planned Parenthood by religious organizations would not be at issue. There is the thing about religious institutions already providing such health insurance for their employees (e.g., DePaul University in Chicago).     Did President Obama cave to the Republican Party on single-payer? Did President Obama, and a lot of members of Congress, receive very nice campaign contributions from the health mega-industry? On the latter—yes.

   The debate over Planned Parenthood and the Komen Foundation is one of those splinter issues Karl Rove loves to exploit. And here I thought that, with disagreement over gay rights fading into the sunset, splinter issues were gone and we could concentrate on the real issues of the campaign, like building colonies on the Moon.

   If we had single-payer, I am confident I would pay less than a thousand dollars per year in taxes that would go to health care. Even if the amount were as high as it is now, I would rather pay the government that money for health care. Instead, I pay for private health insurance so that the CEO of the company can invest her bonuses overseas. If my money stayed here at least the bureaucrats my money employed would be more likely to spend their money on American soil. There would be jobs created here.

   And maybe our World ranking in health care would move up a few notches and we’d all live a few years longer.

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Comment by Bob Haiducek on February 13, 2012 at 12:02am

In an earlier post I mentioned the cost-cutting of over $400 billion per year. I meant to link to the Improved Efficiency web page that gives some explanation about the cost-cutting and the source of the $400 billion estimate.

As highlighted at that web page, the United States currently has two choices:
A. --- proceed with getting single-payer health care:  
               CUT SPENDING by $400 billion per year
B. --- continue the implementation of Obamacare: 
               INCREASE spending by $300 billion over ten years.

What a choice ---- Let's go with  "A"

- Bob the Health and Health Care Advocate

Comment by Bob Haiducek on February 12, 2012 at 9:38pm

                      IT WOULD BE BEST TO ... 


  1 of 5,    ..........     through      ............    5 of 5

Comment by Bob Haiducek on February 12, 2012 at 9:32pm

/// set of multiple postings to reply to Nicolas Martin /// ----- 5 of 5

Reply --------------------

Personal behavior is a factor in health. There was a world obesity epidemic declared years ago. That's a problem. There are global economic problems and problems with access to care in the poorest areas of the United States. Americans go to the doctor FAR less often than other countries.

It's a special problem when comparing to Japan, because one of the most extreme differences between Japan and the United States is physician visits. The Japanese go to the doctor over three times as often. There can be a positive impact on personal behavior when the system allows people to go to the doctor beyond going to the emergency room, where they give little or no time to personal behavior / habits.

Improved Medicare for All, is about changing from an estimated maximum 69% efficiency to an estimated minimum 95% efficiency and establishing health care for all in the United States. Then we'll have at least a little better chance of improving personal behavior(s).

I have no comment about the complaining you have done about Mr. Small (and me in a different post)other than the fact that it does not seem appropriate.

- Bob the Health and Health Care Advocate

Comment by Bob Haiducek on February 12, 2012 at 9:31pm

/// set of multiple postings to reply to Nicolas Martin /// ----- 4 of 5

Reply --------------------
About the U.S. being 37th in ranking according to the World Health Organization: that number is old, over-used and is a questionable reference, just like you indicated. It's used often by others, so we have information and details about it at the website. However, I generally never reference it.

See other answers for many sources.

4. By Nicolas: Life expectancy in the U.S. is heavily influenced by controllable personal behaviors. Smoking, diet, illicit drug use, homicides, and sexual promiscuity all substantially influence life expectancy,  yet the quality of medical care is responsible for none of those. American infant mortality is influenced greatly by personal behaviors that lead to prematurity, but American medicine saves babies that would be allowed to die in other countries. An unusually high percentage of residents are fairly recent and lower-income immigrants, who often have higher mortality risks. (For instance, about 80 percent of Burmese refugees arrive infected with H. pylori, which causes ulcers and stomach cancer.) Nevertheless, life expectancy in the U.S. is only modestly behind other countries which do not share our social pathologies and risk factors, and the situation is improving rapidly here.  According to the latest CDC data*, the life expectancy of a female in America in 2010 was 81.1 years and for a male it was 76.2 years. That puts U.S. women 5 years and men 2.8 years behind  the world leader, Japan, which is famously insular and prohibitive of immigration. I defy you to find a single factor associated with better medical care that is responsible for higher Japanese than American life expectancy. (In 1900, aggregate life expectancy in the U.S. was less than 50 years.

Comment by Bob Haiducek on February 12, 2012 at 9:28pm

/// set of multiple postings to reply to Nicolas Martin /// ----- 3 of 5

2. By Nicolas: The cost of medical care in the U.S. began its unabated ascent in the 1960s, when government started pouring vast sums into the market. Cost reflects supply and demand. Government money has vastly increased demand, and government  regulations have stifled supply. The supplies of doctors, nurses, dentists, drugs, and devices are tightly controlled by cartels and government regulations. For instance, while the population of the U.S. has increased in the past 30 years, the number of practicing dentists has remained static. So, the supply of dental care has declined relative to demand and prices have skyrocketed.

Reply --------------------

Timing and Cause of U.S. Problem. Correction: The cost of medical care in the U.S. began its out-of-control ascent in the 1970's as equally seen in a comparison to 30 countries and a comparison to Canada.

As copied today from the Medicare for All website: "Out-of-control U.S. health care costs, compared to other countries, started shortly after the U.S. started an increased focus on private health insurance companies via “managed care” and health maintenance organizations (HMO’s), while maintaining the private health insurance companies. That activity in the United States occurred shortly after the 1883-1972 period during which the majority of other free-market countries had completed their implementations of their health care for all systems, which allow them to have health care costs much more "in control" than the United States."

Regarding the remainder of point 2: It's impossible to reply to this reference about "vast sums" and "cartels" and "government regulations" without having explanations with sources. There are a lot of words there without substance; for example, where in the "market" did all these vast sums go?

3. By Nicolas:  For some reason you (Mr. Small) are shy about providing exact sources for your statistical claims. You don't say who rates "health care quality," but you presumably refer to the ranking by the World Health Organization. You repeat the common misconception about the WHO ranking. It is not exclusively,  or even mostly, a reflection of care quality. It evaluates other factors with a heavy bias in favor of government-provided payment schemes.

Comment by Bob Haiducek on February 12, 2012 at 9:25pm

/// set of multiple postings to reply to Nicolas Martin /// ----- 2 of 5

B. Our waste of money due to inefficency.

1) Our three types of health care bureaucracy each have unnecessary administrative functions and activities that are a massive cost-cutting opportunity of over $400 billion per year.

2) Our overall complexity instead of simplicity:
We spend 69% or less of our health care dollars on health care.
   (oops, the flow chart indicates 69% or more and should be "or less")
We COULD be spending 95% or more of our health care dollars on health care.

C. Our unnecessary hardships

--- Americans experience a long list of hardships, which are a major outcome of major medical bills (which do not occur in other free-market countries) and "simply" the high cost of health care, which does not occur in other free-market countries, where they spend 40% of how much we pay per person. The long list includes these specific stories: the homeless, the financially ruined, the suicides and the HUNDREDS of thousands of medical-related bankruptcies.

D. The high cost of health care in the U.S. has been a major contributor to our loss of millions of jobs, starting in the 1980's and continuing today. [Comment about this:  the best results of implementing single-payer health care, improved Medicare for All are that the lowering of health care costs will not only provide Americans with health care peace of mind, but will also provide business cost reductions that can lead to the recovery of jobs and the addition of jobs. That activity of job recovery and job additions will come just in time for health care, since the new "industry" of medical tourism has been already starting to ramp up, projected to cause us to have a net loss of patient business to other countries of about one million within two years.

There might be more, but I respectfully suggest that there is plenty of evidence that the U.S. out-of-control health care spending IS a problem.

Comment by Bob Haiducek on February 12, 2012 at 9:18pm

/// set of multiple postings to reply to Nicolas Martin /// ----- 1 of 5

Reply to a February 20, 2012 4-point set of comments by Nicolas Martin on February 10:

1. By Nicolas: Higher spending per capita is not necessarily indicative of a problem.  ...  (this topic may be) an utterly meaningless point without further evidence.

Reply --------------------

[In composing this additional post(s) of reply to Nicolas Martin I thought about the words of an American named Isaac who has been living in Australia and Japan. Isaac's words are part of his testimonial. Take a look, and notice that Isaac wrote those words almost four years ago, and all we have as a kind of "reply" now is an insult to American called "Obamacare".]

Yes, spending per capita alone does not necessarily indicate a problem. You indicate that you want further evidence. Excellent. Good idea. We have a list of evidence below.


A. Our amazingly poor health outcomes.

1) Life Expectancy. Our life expectancy is much lower than it should be considering the high spending per person. Relative to other countries our life expectancy has been decreasing.

2) Preventable Deaths Under Age 75. We were bad (15th) and, five years later (2008 report) we were LAST (19th) among 19 free-market countries in the number of unnecessary deaths due preventable causes under age 75. Select the links to see the list and see an associated bar chart.

[Comments: Most Americans would probably find that information to be incredible. And those same Americans might be the ones most surprised when we cut hundreds of billions of wasted dollars that occurred in our current complex way to pay for health care, as we implement health care for everyone.]

3) Maternal Mortality. Our mothers die at an incredibly high rate, considering the amount of money that we spend.

(Note: Maternal mortality is the number of deaths of women during pregnancy, childbirth or in the 42 days after delivery. It is a more solid number to report than infant mortality, for which some people make into a debatable topic.)

4) Physician Visits. One more example is the "proof" that Americans do not get to use the high-priced equipment and facilities that we have. Take a look at the dismal number of physician visits per year ...

Comment by Bob Haiducek on February 12, 2012 at 9:48am

Thanks, Mr. Small, for signing up for the education and communications campaign, Million Letters for Health Care. And thanks for your overall feedback of "compelling" regarding the information that I composed based on our website. It helps confirm that our Medicare for All Teams are going in the right direction.

Since this interaction with you and Nicolas had already initiated some improvements at the website ... and has initiated a much better presentation of the information at the Fraud web page (some accomplished this morning; more improvements will be made) please consider yourself as a contributor to the website. We always greatly appreciate reviews and feedback that lead to refinements.

Bottom Line about Canada. Some Canadians will tell you that they can complain about anything, including health care, just as much as any other country. The inputs that Canadians gave you about not wanting to swap their system fits with the polling results about roughly 90% liking their health care system.

- Bob the Health and Health Care Advocate

Comment by Mark Small on February 12, 2012 at 7:06am

btw, I signed up for the Million Letters for Health Care.

Comment by Mark Small on February 12, 2012 at 7:03am

Mr. Haiducek,

   I found the items you reference quite compelling.

   As for fraud on the system, that is perpetrated far more by private clinics than by individuals seeking treatment. Single-payer eliminates much of the opportunity and reason for fraud.

   As to the wait times claimed by Mr. Martin, I read the critique of the Fraser Institute’s reports. Also, while I understand the shortcomings of anecdotal matters, when we have been in Canada I have taken every opportunity to as Canadians about their health care system. While most of the people with whom I spoke had criticisms of their system, none would swap for the system we have here.

   As for Mr. Martin’s questioning the accuracy of per capita expenditures as a gauge of what we pay for health care, I will do more research. However, the statistics are borne out in my experience. I pay nearly a thousand dollars a month for health insurance. I have a $2,500 deductible. My premiums have risen sharply in the last three or four years as the bonuses for the top executives of the insurance company have risen. One may talk about computers and Zimbabwe all that one wants, but when I was on staff at Northwestern in Chicago (the main campus is in Evanston but the law school is on Lake Shore Drive just north of Navy Pier), I paid (if memory serves me correctly) about $35 per month for HMO coverage. There was no deductible.

   I believe medical doctors should be well paid. I believe nurses, various techies, and other hospital personnel should receive good compensation as well. The money we pay for this health care system, however, does not go to health care, but to bonuses and other profits for insurance carriers. Insurance carriers profit by taking in premiums and not having to pay out benefits. Health insurance companies are exempt from antitrust laws. Therefore health insurance companies profit by denying coverage when they can. And bad faith lawsuits are of little use. For example, Indiana has neutered punitive damages (capped at $75K with the money being paid into the state) as a mechanism of enforcement of rights. So if an insurance company denies claims on a regular basis and gets hit with a couple of lawsuits—that it will drag out as long as possible—here and there, cost-benefit analysis says the insurance company wins. Also remember that Indiana has one of the most regressive medical malpractice statutes in the country (written as it was, by Governor and Doctor Otis Bowen).


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